门诊糖尿病合并高血压患者降压药物使用依从性及影响因素

Compliance and Influential Factors of Anti-hypertensive Drugs in Outpatients with Diabetes Accompanying Hypertension

目的:分析门诊糖尿病合并高血压患者降压药物使用依从性及影响因素。方法:选取2015年1月-2018年12月于笔者所在医院门诊就诊并建立门诊病历的220例糖尿病合并高血压患者,采用自制调查问卷收集并统计患者年龄、性别、收入、用药种类等信息。采用Logistic回归分析法分析降压药物使用依从性的影响因素。结果:220例患者用药依从率为33.6%;依从性好患者收入、文化水平、高血压知识了解程度均高于依从性差患者,病程短于依从性差患者,口服药物(包括降糖药及降压药)种类、不良反应、曾到其他医院就诊、每日食盐摄入>6 g均少于依从性差患者,有高血压家族遗传史、有糖尿病并发症均多于依从性差患者,差异均有统计学意义(P<0.05);Logistic回归分析显示,收入、病程、口服药物种类、文化水平、高血压知识、不良反应、高血压家族遗传史、曾到其他医院就诊、糖尿病并发症、每日食盐摄入>6 g均是糖尿病合并高血压患者降压药使用依从性的影响因素(P<0.05)。结论:门诊糖尿病合并高血压患者降压药物使用依从性较低,收入低、病程长、口服药物种类多、文化水平较低、高血压知识了解较少、存在不良反应、无高血压家族遗传史、曾到其他医院就诊、无糖尿病并发症、饮食偏咸均会影响用药依从性,应对此类患者加强用药教育及管理。

Objective:To analyze the compliance and influential factors of anti-hypertensive drugs in outpatients with diabetes accompanying hypertension.Method:From January 2015 to December 2018,a total of 220 outpatients with diabetes accompanying hypertension were selected and their medical records were established in our hospital.Patients’informations such as age,gender,income and medication types were collected and calculated through self-made questionnaire.The influential factors of compliance with anti-hypertensive drugs were analyzed through Logistic regression analysis.Result:The compliance rate of the 220 patients was 33.6%.Patients with good compliance had higher income,higher education level and higher knowledge of hypertension than those with poor compliance,and the course of disease was shorter than those with poor compliance,and the medication types(including hypoglycemic drugs and anti-hypertensive drugs),adverse reactions,visited to other hospitals,and daily salt intake>6 g were less than those with poor compliance,and with family history of hypertension and diabetic complications were more than those with poor compliance,and the differences were statistically significant(P<0.05).The result of Logistic regression analysis showed that the income,course of disease,medication types,education level,knowledge of hypertension,adverse reactions,family history of hypertension,visited to other hospitals,diabetic complications and daily salt intake>6 g were influential factors of anti-hypertensive drugs in patients with diabetes accompanying hypertension(P<0.05).Conclusion:For outpatients with diabetes accompanying hypertension,the compliance with anti-hypertensive drugs is low.Low income,long course of disease,much medication types,low education level,less knowledge of hypertension,with adverse reactions,without family history of hypertension,visited to other hospitals,without diabetic complications and partial salty diet can affect compliance with drugs.Therefore,education and management of drugs should be strengthen for these patients.